地西他滨联合维生素C治疗骨髓增生异常综合征的疗效及机制  

Efficacy and mechanism of decitabine combined with vitamin Cin the treatment of myelodysplastic syndrome

作　　者：杨福冬 程丽华 徐锋[1] 张娜[1] 周婕[1] 傅媛媛 Yang Fudong;Cheng Lihua;Xu Feng;Zhang Na;Zhou Jie;Fu Yuanyuan(Hematology Department of Deyang People's Hospital,Deyang,Sichuan 618099,China)

机构地区：[1]德阳市人民医院血液科,四川德阳618099

出　　处：《现代临床医学》2024年第2期93-96,108,共5页Journal of Modern Clinical Medicine

基　　金：德阳市科技计划项目(重点研发)(2020SZZ092)。

摘　　要：目的:评估地西他滨联合维生素C治疗骨髓增生异常综合征(MDS)的疗效及机制。方法:选取2020年9月至2022年9月在我院初诊MDS患者78例为研究对象,根据患者选择的不同化疗方式分为两组,观察组(38例)应用地西他滨联合维生素C方案治疗,对照组(40例)单独应用地西他滨治疗,评估两组疗效。所有患者进行MDS相关突变基因检测,分析突变基因特点及与疗效的关系。结果:观察组治疗总反应率高于对照组(76.32%vs55.00%,P<0.05)。MDS患者基因突变检出率为71.79%,TET2突变患者治疗有效率高于对照组(100.00%vs 55.56%,P<0.05)。结论:MDS患者易发生基因突变,地西他滨联合维生素C较单独应用地西他滨治疗MDS临床疗效更显著,且反应应答率高,其机制可能与维生素C激活肿瘤细胞TET2的表达,增强去甲基化作用有关。Objective:To evaluate the efficacy and mechanism of decitabine combined with vitamin C in the treatment of myelodysplastic syndrome(MDS).Methods:78 newly diagnosed MDS patients in our hospital from September 2020 to September 2022 were selected as the study subjects.They were divided into two groups based on the different chemotherapy methods chosen by the patients.The observation group(38 cases)received treatment with decitabine combined with vitamin C regimen,while the control group(40 cases)received treatment with decitabine alone.The therapeutic effects of the two groups were evaluated.All patients underwent MDS related mutation gene testing to analyze the characteristics of mutation genes and their relationships with therapeutic efficacy.Results:The total response rate of the observation group was higher than that of the control group(76.32%vs 55.00%,P<0.05).The detection rate of gene mutations in MDS patients was 71.79%,and the treatment effectiveness rate of TET2 mutation patients was higher than that of the control group(100.00%vs 55.56%,P<0.05).Conclusion:MDS patients are prone to genetic mutations,and the combination of decitabine and vitamin C is more effective and has a higher response rate in the treatment of MDS compared to using decitabine alone.The mechanism may be related to the activation of tumor cell TET2 expression by vitamin C which enhances demethylation.

关 键 词：骨髓增生异常综合征 地西他滨 维生素C 基因突变 二代测序 

分 类 号：R552[医药卫生—血液循环系统疾病]